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Nutrition Therapy for High Cholesterol

A plan called Therapeutic Lifestyle Changes (TLC) can help people who have high amounts of cholesterol in their blood. Following the TLC plan can help reduce the low-density lipoprotein, or LDL, cholesterol (also called bad cholesterol) in your blood. High-density lipoprotein cholesterol (sometimes called good cholesterol) helps rid your body of LDL cholesterol.

Keys to TLC
Limit saturated fats and trans fats: Foods high in saturated fats include fatty meat, poultry skin, bacon, sausage, whole milk, cream, and butter. Trans fats are found in stick margarine, shortening, some fried foods, and packaged foods made with hydrogenated oils. Instead of butter or stick margarine, try reduced-fat, whipped, or liquid spreads. Limit the amount of cholesterol that you eat to less than 200 milligrams (mg) per day. Foods high in cholesterol include egg yolks (one egg yolk has about 212 mg of cholesterol), fatty meat, whole milk, cheese, shrimp, lobster, and crab. Eat more omega-3 fats (heart-healthy fats): Good choices include salmon, tuna, mackerel, and sardines. Aim to eat fish twice a week. Other foods with omega-3 fats include walnuts and canola and soybean oils. Flaxseed is another source of omega-3 fats. Have it as flaxseed oil or ground flaxseed. Keep the total amount of fat that you eat (including heart-healthy fats) to 25% to 35% of the calories that you eat. If you should eat 2,000 calories per day, your fat intake can be between 50 grams (g) and 75 g per day. Get 20 g to 30 g of dietary fiber per day: Fruits, vegetables, whole grains, and dried beans are good sources of fiber: Aim for 5 cups of fruits and vegetables per day. Have 3 ounces (oz) of whole grain foods every day. Plan to eat more plant-based meals, using beans and soy foods for protein. Talk with your dietitian or doctor about what a healthy weight is for you. Set goals to reach and maintain that weight. Talk with your health care team to find out what types of physical activity are best for you. Set a plan to get about 30 minutes of exercise on most days.

Copyright American Dietetic Association. This handout may be duplicated for client education. Nutrition Therapy for High Cholesterol Page 1

Recommended Foods
Food Group Grains Recommended Foods Whole grain breads and cereals, including oats and barley Pasta, especially whole wheat or other whole grain types Brown rice Low-fat crackers and pretzels Fresh, frozen, or canned vegetables without added fat or salt Fresh, frozen, canned, or dried fruit Nonfat (skim), low-fat, or 1% fat milk or buttermilk Nonfat or low-fat yogurt or cottage cheese Fat-free and low-fat cheese Lean cuts of beef and pork (loin, leg, round, extra lean hamburger) Skinless poultry Fish Venison and other wild game Dried beans and peas Nuts and nut butters Meat alternatives made with soy or textured vegetable protein Egg whites or egg substitute Cold cuts made with lean meat or soy protein Unsaturated oils (olive, peanut, soy, sunflower, canola) Soft or liquid margarines and vegetable oil spreads Salad dressings Seeds and nuts Avocado

Vegetables Fruits Milk

Meat and Other Protein Foods

Fats and Oils

Copyright American Dietetic Association. This handout may be duplicated for client education. Nutrition Therapy for High Cholesterol Page 2

Foods Not Recommended

Food Group Grains Foods Not Recommended High-fat bakery products, such as doughnuts, biscuits, croissants, danish pastries, pies, cookies Snacks made with partially hydrogenated oils, including chips, cheese puffs, snack mixes, regular crackers, butter-flavored popcorn Fried vegetables Vegetables prepared with butter, cheese, or cream sauce Fried fruits Fruits served with butter or cream Whole milk 2% fat milk Whole milk yogurt or ice cream Cream Half-&-half Cream cheese Sour cream Cheese Higher-fat cuts of meats (ribs, t-bone steak, regular hamburger) Bacon Sausage Cold cuts, such as salami or bologna Corned beef Hot dogs Organ meats (liver, brains, sweetbreads) Poultry with skin Fried meat, poultry, and fish Whole eggs and egg yolks Butter Stick margarine Shortening Partially hydrogenated oils Tropical oils (coconut, palm, and palm kernel oils)

Vegetables Fruits Milk

Meat and Other Protein Foods

Fats and Oils

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Sample 1-Day Menu

Meal Food Choices Breakfast cup apple juice cup oatmeal with 1 small banana and 1 cup skim milk 1 cup brewed coffee Turkey and cheese sandwich: 2 slices whole wheat bread, 2 oz lean deli Lunch turkey breast, 1 oz low-fat Swiss cheese, mustard, 1 medium sliced tomato, shredded lettuce 1 pear 1 cup skim milk Evening 3 oz broiled fish 1 cup brown rice with 1 teaspoon soft margarine Meal 1 medium stalk broccoli and 1 medium carrot Tossed salad with mixed greens, tomatoes, chickpeas, and olive oil and vinegar dressing 1 small whole grain roll with 1 teaspoon soft margarine 1 cup tea cup nonfat frozen yogurt with fruit 1 oz trail mix made with nuts, seeds, raisins, and other dried fruit Snacks 1 cup blueberries 1 cup skim milk Approximate Nutrition Analysis: Calories: 1,968; Protein: 105g (21% of Calories); Carbohydrate: 311g (61% of calories); Fat: 42g (18% of calories), Saturated Fat: 9g; Cholesterol: 110mg; Sodium: 1,762mg; Fiber: 37g

Additional Resource
More in-depth information on TLC is available at: http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.htm Notes:

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